Berger R, Söder S
Marienhaus Klinikum St. Elisabeth, Department of Obstetrics and Gynecology, 56564 Neuwied, Germany.
Biomed Res Int. 2015;2015:257139. doi: 10.1155/2015/257139. Epub 2015 Jan 11.
Preterm infants born before the 30th week of pregnancy are especially at risk of perinatal brain damage which is usually a result of cerebral ischemia or an ascending intrauterine infection. Prevention of preterm birth and early intervention given signs of imminent intrauterine infection can reduce the incidence of perinatal cerebral injury. It has been shown that administering magnesium intravenously to women at imminent risk of a preterm birth leads to a significant reduction in the likelihood of the infant developing cerebral palsy and motor skill dysfunction. It has also been demonstrated that delayed clamping of the umbilical cord after birth reduces the rate of brain hemorrhage among preterm infants by up to 50%. In addition, mesenchymal stem cells seem to have significant neuroprotective potential in animal experiments, as they increase the rate of regeneration of the damaged cerebral area. Clinical tests of these types of therapeutic intervention measures appear to be imminent. In the last trimester of pregnancy, the serum concentrations of estradiol and progesterone increase significantly. Preterm infants are removed abruptly from this estradiol and progesterone rich environment. It has been demonstrated in animal experiments that estradiol and progesterone protect the immature brain from hypoxic-ischemic lesions. However, this neuroprotective strategy has unfortunately not yet been subject to sufficient clinical investigation.
妊娠30周前出生的早产儿尤其有围产期脑损伤的风险，这通常是脑缺血或上行性宫内感染的结果。预防早产并在出现宫内感染迹象时进行早期干预可降低围产期脑损伤的发生率。研究表明，对有早产风险的女性静脉注射镁可显著降低婴儿患脑瘫和运动技能障碍的可能性。还证明，出生后延迟结扎脐带可将早产儿脑出血率降低多达50%。此外，在动物实验中，间充质干细胞似乎具有显著的神经保护潜力，因为它们可提高受损脑区的再生率。这些类型的治疗干预措施的临床试验似乎即将开展。在妊娠晚期，雌二醇和孕酮的血清浓度显著增加。早产儿突然脱离了这种富含雌二醇和孕酮的环境。动物实验已证明，雌二醇和孕酮可保护未成熟脑免受缺氧缺血性损伤。然而，遗憾的是，这种神经保护策略尚未得到充分的临床研究。
